Adjunctive use of antibiotics in periodontal therapy.
Adjunctive use of antibiotics in periodontal therapy.
复制标题
抗生素在牙周治疗中的辅助使用。
DOI：
10.17096/jiufd.90144
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发表时间：
2015
影响因子：
--
通讯作者：
Cintan S
中科院分区：
文献类型：
--
作者：
Barca E;Cifcibasi E;Cintan S
牙周病是具有混合微生物病因学和显著炎症反应的感染性疾病，导致下层组织的破坏。牙周病治疗的目的是消除与疾病有关的病原体，并获得牙周健康。牙周炎通常通过非手术机械清创和定期牙周维护护理来治疗。牙周手术可能适用于某些患者，以改善对根面的接触;然而，单独的机械清创术可能并不适用于所有病例。在这种情况下，连续的全身抗生素治疗仍然是治疗的选择。它可以通过血清到达深层牙周袋和分叉区域底部的微生物，也会影响牙龈上皮和结缔组织内的微生物。本文旨在提供一个更新的临床问题，何时以及如何处方全身抗生素牙周治疗。讨论的要点是抗生素的作用方式，敏感的牙周病原体，抗生素剂量，抗生素在牙周病治疗中的使用，以及细菌对每种抗生素的耐药性机制。
Periodontal diseases are infectious diseases with a mixed microbial aetiology and marked inflammatory response leading to destruction of underlying tissue. Periodontal therapy aims to eliminate pathogens associated with the disease and attain periodontal health. Periodontitis is generally treated by nonsurgical mechanical debridement and regular periodontal maintenance care. Periodontal surgery may be indicated for some patients to improve access to the root surface; however, mechanical debridement alone may not be helpful in all cases. In such cases, adjunctive systemic antibiotic therapy remains the treatment of choice. It can reach microorganisms at the base of the deep periodontal pockets and furcation areas via serum, and also affects organisms residing within gingival epithelium and connective tissue. This review aims to provide an update on clinical issues regarding when and how to prescribe systemic antibiotics in periodontal therapy. The points discussed are the mode of antibiotic action, susceptible periodontal pathogens, antibiotic dosage, antibiotic use in treatment of periodontal disease, and mechanism of bacterial resistance to each antibiotic.